SUMMARY:
Reports to Manager of Ambulatory
Coding and works with Manager of Coding to develop workflow processes and
provides direction and supervision to staff responsible for accurately coding
medical records, auditing charts and resolving work queue edits, EDI error and
payor denials associated with coding related issues. Collaborates with the overall physician revenue
cycle department to meet the metrics, mission, vision and values of the
Brown University Health Organization.
Brown University Health employees are expected to successfully role model the organization’s values of Compassion, Accountability, Respect and Excellence, as these values guide our everyday actions with patients, customers and one another.
In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:
Instill Trust and Value Differences
Patient and Community Focus and Collaborate
In addition, our leaders will demonstrate an aptitude for:
Ensure Accountability and Build Effective Teams
Drive Vision and Purpose and Optimize Work Processes
By applying core and leadership competencies, leaders help Brown University Health achieve its strategic goals.
RESPONSIBILITIES:
Supervises the coding
activities for any area or a combination of the following: observation, partial
hospital, dialysis, radiology, radiation oncology, VIR, NIR, Cath Lab, pathology, lab, ambulatory clinics (adult
and/or pediatric, cardiovascular institute, oncology), ambulatory surgery, emergency
department, anesthesia, office and hospital professional coding . Ensures
highest level of accuracy, completeness and timeliness of processes in code assignment.sEnsures consistency and efficiency in outpatient
claims processing and data collection to optimize reimbursement and facilitate
data quality in outpatient services.
Consistently applies the
corporate values of respect, honesty and fairness and the constant pursuit of
excellence in improving the health status of the people of the region through
the provision of customer-friendly, geographically accessible and high-value
services within the environment of a comprehensive integrated academic health
system. Is responsible for knowing and
acting in accordance with the principles of the Brown University Health Corporate Compliance
Program and Code of Conduct.
Monitors unbilled accounts
for uncoded or outstanding accounts to ensure the cases is completed within 2-3
days of discharge. Maintains efficient
workflow in coding and clerical processes.
Prioritizes high paying accounts.
Monitors staff productivity and accuracy to ensure requirements are met. Reviews bill
hold reports for physician queries and contact physicians who are not
responding.
Provides training and
education to staff in the use of coding guidelines and practices, proper
documentation techniques, medical terminology and disease processes,
appropriate to the job description.
Participating with the coding validators, communicates to staff any
coding updates. Ensures external coding
staff (agency coders) understands and agrees to adhere to the organization’s
coding and policies, when applicable. Serves as a resource to department staff and other health care professionals in need of
coding assistance, responding to questions.
Researching complex coding issues, finding solutions and updating staff
and practices as needed.
Performs coding validation
for outpatients as required. May be required to perform coding in instances of
staff shortages. Supervises outpatient coders
as required.
Maintains knowledge of
current professional coding certification requirements. color:redEnsures staff is thoroughly trained in usage
of ICD-10 and/or CPT coding procedures in order to optimize reimbursement to Brown University Health
for its services.
Maintains knowledge of
current payor policies and procedures including medical necessity and stays up
to date with CMS and all third party regulations.
Ensures effective
recruitment, selection, development and evaluation of coding and clerical staff
to optimize achievement of goals and objectives.
Prepares payroll, submits
work orders as needed for departmental upkeep and orders supplies. Performs
employee appraisals as necessary
Abides by the Standards of
Ethical Coding as set forth by the American Health Information Management
Association and the American Association of Professional Coders. Monitors
coding staff for violations and reports to Coding Manager or Director when
areas of concern are identified.
MINIMUM QUALIFICATIONS:
BASIC KNOWLEDGE:
Associate Degree or
equivalent in a health services discipline .
CPC coding certification
required from AAPC or AHIMA.
b font-size: 1emEXPERIENCE:
Three to five years
progressively responsible experience performing outpatient coding preferably in
a similar setting and operationally complex healthcare environment.
One to two years supervisory
experience strongly preferred.
Experience should demonstrate
a high level of knowledge in ICD-10-CM and CPT-4 coding methodologies.
Effective written and oral
communication skills, effective leadership/management skills, and familiarity
with automated systems required.
WORKING CONDITION AND PHYSICAL REQUIREMENTS:
span lang=FR ;mso-ansi-language:
FRNormal office environment.
INDEPENDENT ACTION:
p class=MsoHeader
p class=MsoHeaderPerforms independently within
the department’s policies and procedures.
Refers specific complex problems to the supervisor when clarification of
the departmental policies and procedures are required.
SUPERVISORY RESPONSIBILITY:
Supervisory responsibility
for up to 20 FTEs.
Pay Range:
$64,480.00-$106,412.80
EEO Statement:
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.
Location:
535 Faunce Corner Road - 535 Faunce Corner Road North Dartmouth, Massachusetts 02747
Work Type:
M-F 7:30am-4pm
Work Shift:
Day
Daily Hours:
8 hours
Driving Required:
No